COVID-19 (2): Turns out it's going to be pretty bad actually

https://www.nbcnews.com/news/amp/live-blog/ncna1189306?__twitter_impression=true

NBC news website sucks. Anyways Texas abortion ban has expired.

I posted the other day about my wife heading back to her job as an ICU nurse in a week or maybe taking FMLA for a while (thanks @Riverman that was an option we hadnā€™t thought of and it looks like it will work if she chooses it).

We had a conversation tonight about that where she asked if she thought we had become conspiracy theorists. We both have pretty dim views on the whole thing. My response was to basically say that I am sure it looks like that to many/most as I have been posting dire predictions on social media for almost 2 months. But i donā€™t know if I/we really are or not.

In short I donā€™t think your average human mind is well equipped to grapple with a once in a lifetime black swan event that is this complicated very well. Especially not on day 40 of quarantine.

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Iā€™ve read theories that the reason flu season is in the winter is the cold dry air, and dry heat indoors dries out our nasal passages. I could think of reasons why the virus would be stronger and reproduce more in ideal conditions.

The virus seems to like cold, dry air between 20 and 40 degrees - Iā€™ve posted several studies to that effect. It rarely gets that cold in the Bay Area and itā€™s pretty wet in the winter generally - and itā€™s not dry in Seattle or Portland. https://www.nytimes.com/2020/03/22/health/warm-weather-coronavirus.html

Iā€™m not saying itā€™s likely - but weather is a possible variation between the regions that got hit hard and those that didnā€™t - along with this weaker strain idea. Or maybe something else.

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Is your first impulse to make a Tiger King joke or to ask who the hell is having sex with cats?

https://twitter.com/brian_schnee/status/1253017628911628290

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Bruh.

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https://www.nature.com/articles/s41591-020-0869-5

Our analysis suggests that viral shedding may begin 2 to 3 days before the appearance of the first symptoms. After symptom onset, viral loads decreased monotonically, consistent with two recent studies8,9. Another study from Wuhan reported that virus was detected for a median of 20 days (up to 37 days among survivors) after symptom onset10, but infectiousness may decline significantly 8 days after symptom onset, as live virus could no longer be cultured (according to Wƶlfel and colleagues11). Together, these results support our findings that the infectiousness profile may more closely resemble that of influenza than of SARS (Fig. 1a), although we did not have data on viral shedding before symptom onset6,12. Our results are also supported by reports of asymptomatic and presymptomatic transmission13,14.

Thatā€™sā€¦thatā€™s not how this works.

For what itā€™s worth, this uses a Goldman Sachs economic forecast that calls for a 19% surge in GDP in Q3, which isnā€™t going to happen if we continued social distancing.

So at best it relies on massive testing and contact tracing efforts being in place nationwide by July 1.

As a result, if you priced in months more of social distancing youā€™d probably end up with the opposite result.

To me the answer is clear (UBI and shutdowns buying us time to max out all relevant capacities ā†’ slowly easing shutdowns and relying on testing and tracing while easing UBI and relying on expanded UI as people return to work)ā€¦ All paid for by a one-time wealth tax.

But USA#1 is never going to do that which leaves us with a choice between two awful poison pills.

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So whoā€™s loading up on nicotine patches?

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As an outsider of the medical field, my perception is that all patients are potential case studies.

If morons want to demand radical freedom, let them benefit us?

Description of restaurant life in HK. I guess there will always be some demand for places where someone else cooks and does the dishes, but the whole sense of restaurants as celebratory venues seems like itā€™s going to be dead for a while.

Milan, Madrid and Barcelona in March have very similar temperatures to the Bay Area in January and it sure didnā€™t seem like conditions there presented much of a problem to their virus. OK, theyā€™re a little bit drier, but youā€™re getting into very speculative territory there compared to ā€œwe know that NYC had the same strains as Europe and we also have a paper saying that those strains are better at replicating themselvesā€.

I had a large jug of high octane DIY nicotine liquid for e-cigs that I tossed sometime last year. Kinda want it back now.

How about Germany? Did they get the mild strain somehow? If so then this really may be onto something.

If not and Germany is different somehow - well the West Coast is probably more different from NYC and Boston than Italy is from Germany.

I actually think thereā€™s a good chance this strain thing is real. But I also think thereā€™s a good chance thereā€™s some other explanation and Iā€™m just trying to reason through any possible other explanation.

I mean maybe it will come out those two had contact with travelers and the area just got lucky those strains died out before they could really ignite. Santa Clara is pretty spread out, not much public transportation. Do we know that two cases is for sure a sign of significant community transmission?

I was pretty curious about that weird 3-4 week dry cough I got in Dec. and everyone else in LA seemed to get. But my antibody test came back negative. But I also have no faith in my antibody test so who knows.

Also unless Iā€™m doing some math wrong - LA county has 10 million ppl and 729 deaths so far. Letā€™s say that study was off by half and say 2% of LA county has legit antibodies. 729/200,000 = .3% (and 2-3 more weeks of deaths lagging cases). If the 4% in the study is accurate well when all the deaths come in you may be looking at .3% still. Thatā€™s a number for IFR thatā€™s come up a few times in good populations. So I donā€™t know that itā€™s way way off what youā€™d expect anyway?

Iā€™ve always thought NYC was a particularly bad situation due to the combination of population density, cold weather, massive dependence on public transportation and cabs/ubers, lots of immigrants and 2nd/3rd generation immigrants living in the same household or closely located household clusters, and lots of unhealthy people with obesity, heart and other problems in the outer boroughs.

Yes all those exist in places in LA and the Bay Area - but maybe not in the same heady mix. SF is the only place that comes close to NYCā€™s pop. density and dependence on public transportation - and everyone there is rich now. The outer borough equivalent is a bungalow in Daly City that still costs $1M.

So if you told me the IFR of NYC was 1%, and LA was .3% for the same virus - I could see that. Or maybe theyā€™re farther apart and the two strains make a big difference. I could see that too.

If they try that here, the same people protesting the stay at home orders will be protesting the blue stickers, etc. by barging into the blue zone without a sticker. I also suspect youā€™ll have plenty of idiot business owners who just let anyone in without proper checks.

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Germany has been one of the best in terms of testing. They have huge case numbers still, I think their CFR is just lower because they have a better handle on the size of their outbreak.

Edit: Their CFR on current caseload is still like over 3%, and that with a world-class testing capacity, they are having a rough time, they only look good next to like Italy and Spain.

California has something like 1200 deaths so far and if we assume a mortality rate of 2%, then that means that at least 60,000 people in California had itā€¦ two weeks ago, with a lot more people having it today. To me the simplest answer has always been that the testing sucks, whether itā€™s because of false negatives or that weā€™re systematically limiting who gets tested (which is happening), it doesnā€™t exactly matter.

I ordered a monthā€™s worth of ZYN pouches from someplace online. I love 'em.

As does California, Oregon and Washington. Look at their test %s - less than 10% positive is a healthy sign. https://covidtracking.com/data

https://spectator.us/covid-antibody-test-german-town-shows-15-percent-infection-rate/

Data from coronavirus deaths in Gangelt suggests an infection mortality rate of 0.37 percent, significantly below the 0.9 percent which Imperial College has estimated, or the 0.66 percent found in a revised study last week.

Hereā€™s the results from that one town in Germany where they tested everyone - and which was one of the early epicenters in the country.

That guy was spitting mad.

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